Spike in opioid ODs brings where, how people are using drugs into focus

An alarming spike in overdose responses this past weekend in Ottawa has outreach workers concerned about where and how people are using drugs.

Between Saturday and Sunday, paramedics reported more than 30 overdoses across the city. Twenty required treatment in a hospital.

The CEO of Ottawa Inner City Health said his group provides a supervised consumption site, but the problem goes beyond that.

"The majority of overdoses in Ottawa and Ontario, about 70 per cent, are happening in private dwellings," said Rob Boyd.

Marc-Antoine Deschamps, a spokesperson with the Ottawa Paramedic Service, says this isn't isolated to the downtown core. 

"It can happen in any socioeconomic group, and all across the city," Deschamps said. 

Ottawa Public Health (OPH)'s latest, preliminary data shows that in May there were 117 emergency room visits caused by opioid overdoses. That's the second highest monthly total since the agency first began recording that data five years ago, trailing only August 2020.

The same data shows emergency department visits for unintentional opioid overdoses in Ottawa have increased significantly since 2015. It was seen as a problem before that.

In a statement, OPH wrote that the overdose crisis continues to cause significant harm to Ottawa's population and has been exacerbated by the availability of increasingly toxic, unregulated drugs.

Contaminated drug supply still a major factor

Deschamps said it's tough to know what may have caused the spike in overdoses this weekend, but street drugs are unpredictable and can be laced with potent fentanyl or carfentanil. 

"Obviously it's important for everybody to understand that you never know what kind of drug you're taking," Deschamps said. "You cannot know just by looking."

Cross contamination can also increase the risk of an overdose, which can happen by sharing paraphernalia, baggies or scales to weigh drugs. 

"Somebody who's reusing a pipe that was previously used to smoke fentanyl is now also at risk because even trace amounts give high concentrations," Boyd said. 

Stimulant overdoses are also on the rise. 

"People who are expecting that they're using stimulants such as cocaine or crystal meth may in fact be getting some opioids," Boyd said. "If they've never experienced opioids, they are at very high risk of overdose."

Between January 2016 and December 2022, almost 36,500 people died from complications related to opioid overdoses in Canada, according to the federal government's Health Infobase.

Of those accidental apparent opioid toxicity deaths, 81 per cent involved fentanyl and 79 per cent involved opioids that were not made by a pharmaceutical company. 

Trend toward smoking vs. injecting

Boyd also notes that more people seem to be moving away from injecting drugs toward smoking them, which is leading to more overdoses outside of their facility. 

"People can't come into the site to smoke. So, they're smoking just outside the site because they know that we'll respond if they have an opioid overdose." 

People can't smoke drugs inside the supervised consumption site for two reasons: Provincial funding cannot be used for supervised smoking and the occupational health and safety concerns it would create, Boyd said. 

He said they are working to provide a supervised drug consumption space that would accommodate this kind of drug use. It would involve creating a room with proper ventilation that could be evacuated quickly if staff needed to do an intervention, he said. 

Something like this would also require more staffing and additional resources as it would become another space to monitor and respond to.